Impact of Navajo Nation Tax on Junk Food

1项目概要 2纳瓦霍流行病学中心管理纳瓦霍公共卫生信息系统， 3提供数据和报告，为超过330，000名注册人员的健康规划提供信息 四个纳瓦霍部落的成员。他们的报告记录了糖尿病的高患病率 5和肥胖，健康的传统食品供应有限， 6甜饮料为了解决这些问题及其后果，纳瓦霍人 7 Nation于2014年11月通过了健康饮食国家法案（HDNA）。法律包括A 8对几乎没有营养价值的食品（“垃圾食品”）征收2%的税，这是有史以来第一次征收这种税。 9美国。税收收入每年分配给110个地方政府中的每一个。 10个政府实体（分会）开发和支持地方健康项目。执业医师法是 11通过了预期增加的成本将影响食品环境，导致 12减少垃圾食品的消费，并提供可持续的资金来源，以支持 13个地方需要健康规划。 14然而，迄今为止，尚未对该税的影响进行全面评估。 15完成因此，由纳瓦霍流行病学中心组成的研究小组， 16北方亚利桑那大学和哈佛的布里格姆妇女医院当地社区 17附属机构建议研究税收对3个主要组成部分的影响：1）健康章 18个方案由税收支持，2）食品商店环境的变化， 19税收实施后的定价;以及3）含糖饮料的变化， 20水果/蔬菜的摄入量后，税的实施。健康计划将是 21个通过社区发展司的数据进行评估，他们支持 22项目。食品商店环境的变化将通过2013年的一项后续行动进行评估。 23（税前）对纳瓦霍民族83家商店的调查，这也将确定积极的 24个异常值在健康食品供应的变化方面。消费行为将 25通过对独特的纳瓦霍BRFSS进行随访进行评估，这是一个人群范围 26项调查遵循严格的BRFSS方法。该小组有纳瓦霍IRB协议， 27支持每个目标，并得到关键利益相关者的合作支持，使我们处于有利地位 28、实现既定目标。我们相信，这项研究的信息是及时的， 29紧急，将是至关重要的纳瓦霍民族领导作出明智的决定 30关于垃圾食品税的延续。

1 PROJECT SUMMARY 2 The Navajo Epidemiology Center manages Navajo public health information systems, and 3 provides data and reports that inform health programming for the over 330,000 enrolled 4 members of the Navajo tribe. Their reports have documented high prevalence of diabetes 5 and obesity, limited availability of healthy traditional foods, and high rates of consumption of 6 sugar sweetened beverages. To address these issues and its consequences, the Navajo 7 Nation passed the Healthy Diné Nation Act (HDNA) in November 2014. The law includes a 8 2% tax on foods of little-to-no-nutritional value (‘junk foods’), the first-ever such tax in the 9 United States. Revenues from the tax are distributed annually to each of the 110 local 10 government entities (chapters) to develop and support local wellness projects. The law was 11 passed with the expectation that the increased cost would impact the food environment, lead 12 to reduced consumption of junk foods and provide a sustainable source of funds to support 13 local needs for wellness programming. 14 To date, however, a comprehensive assessment of the impact of the tax has not been 15 completed. Therefore, the research team, consisting of the Navajo Epidemiology Center, 16 Northern Arizona University and Harvard’s Brigham and Women’s Hospital local community 17 affiliate propose to study the impact of the tax on 3 major components: 1) chapter wellness 18 programming supported by tax revenue, 2) changes in the food store environment and 19 pricing following the tax implementation; and 3) changes in sugar sweetened beverage and 20 fruit/vegetable intake following the tax implementation. Chapter wellness programming will be 21 assessed via data from the Division of Community Development, who are supportive of the 22 project. Changes in the food store environment will be assessed via a follow-up of a 2013 23 (pre-tax) survey of 83 stores across the Navajo Nation, which will also identify positive 24 outliers in terms of changes in healthy food offerings. Consumption behaviors will be 25 assessed by conducting a follow-up of the unique Navajo BRFSS, which is a population wide 26 survey following rigorous BRFSS methods. The team has active Navajo IRB protocols to 27 support each aim, and have collaborative support from key stakeholders, positioning us well 28 to deliver on the proposed aims. It is our belief that information from this study is timely, 29 urgent and will be essential for the Navajo Nation leadership to make an informed decision 30 about the continuation of the junk food tax.